Sustainability – Meeting Emerging Organizational Needs
 ive years ago, The California Wellness Foundation (TCWF) announced a new emphasis in its grantmaking: awarding core operating support grants to nonprofit health organizations in California. The Foundation’s board of directors believed that with the flexibility provided by these unrestricted funds, grantees could devote their grant dollars to pressing organizational needs that would ensure the sustainability of the health care safety net that provides care to millions of underserved Californians.
 “Core operating support helps underwrite the day-to-day administrative, infrastructure and overhead costs that enable an organization to carry out its mission,” said Gary L. Yates, TCWF president and CEO. “We came to realize that the valuable work accomplished by nonprofit health organizations in California is rooted in their ability to meet basic organizational needs.”
Over the past several years, TCWF grantees have identified needs ranging from using funds to sustain their existing direct health services, to building organizational infrastructures with better information systems or broader fundraising capacities. Organizations often identify needs based on unique issues related to their missions, such as geographical challenges, rapid population growth in their communities, or growing awareness of a previously hidden problem. The following are several examples of how organizations have used core operating support to sustain the level and quality of health services for underserved communities.
Building a Stronger Network
California’s largely rural Central Valley is home to dozens of community health centers that provide health care for thousands of residents who otherwise would not be able to access health care services. The Central Valley Health Network (CVHN) was established in 1998 with the mission of enabling its member health centers to be cost-effective, competitive, and able to provide high-quality patient care to underserved communities across the region.
CVHN received a three-year TCWF grant of $300,000 in June 2004 to sustain the provision of direct preventive health services by its member clinics and to strengthen the network’s infrastructure through provision of training, support and advocacy for network members.
CVHN has used its grant to help fund services that are not reimbursed by the government programs that traditionally fund medical care at community health centers. For example, CVHN used a portion of its grant to partner with a state program to offer nutrition education and exercise promotion services at its member clinics. With a successful pilot effort under its belt, the program qualified for a major demonstration grant that will fund the program.
“We never could have done the pilot project without our TCWF grant because there was nowhere to bill for the costs,” said Yvonne Bice, CVHN executive director. “Now we have an ongoing preventive program that improves the health of patients and their families and also brings $1 million annually to our members.”
CVHN also provides training for staff from its member clinics. This can be challenging in a region as vast as the Central Valley, where clinics may face the choice of keeping their doors open on a particular day or sending staff to workshops in Los Angeles or Oakland. Instead, CVHN brings its trainings to multiple Central Valley locations and holds them at different times of the day.
Another area of focus for CVHN has been building its capacity to advocate on behalf of its members with California policymakers. The network hosts an annual congressional staff luncheon in Washington, D.C. Key legislative staff from each of the 17 congressional offices representing the Central Valley are invited to attend, along with representatives from the network’s member clinics.
Rather than visiting each office individually, the luncheon gives clinics an hour of undivided attention from congressional staff members. They can ask questions about health care services and needs in their districts and update the clinic staff about legislation and federal appropriations.
“For an established organization like CVHN, a core operating support grant can provide flexible resources for new services or projects that don’t fit into existing reimbursement systems,” said Sandra Martínez, TCWF program director. “This is particularly true in a region like the Central Valley, where community health centers play such an important role in providing a safety net for the underserved. This kind of creativity is vital.”
New Program Matches Mentors With At-Risk Youth
 In addition to helping well-established organizations such as CVHN, core operating support grants can also benefit younger organizations with their unique challenges. One 2 One Mentors launched its programs for at-risk youth in the High Desert communities of San Bernardino County in 2000. In 2004, the organization received a three-year TCWF grant of $150,000 to sustain the provision of violence prevention workshops for youth and their families and to match youth with mentors for more intensive one-on-one services, as a violence prevention strategy.
High Desert communities like Victorville, Apple Valley and Hesperia have grown rapidly in recent years, as families from Los Angeles have moved to the area in search of more affordable housing and less congested neighborhoods. For adolescents, such transitions can be challenging. Also, these communities have significant numbers of low-income families facing difficult economic challenges and family situations. Youth confront negative peer pressure, while positive after-school or recreational opportunities are scarce in this region, where the nonprofit infrastructure has not kept up with the region’s rapid growth. As a result, health issues such as substance abuse among young people have risen dramatically and injury and death from increased violence has been recorded.
“Preventing violence against youth is an important strategy for improving health outcomes for at-risk youth in these communities,” said Nicole J. Jones, TCWF program director. “Creating positive relationships with a trusted adult mentor has been documented as an effective approach to helping youth avoid violent situations.”
One 2 One Mentors has used its core operating support grant to build organizational infrastructure in areas such as financial accounting and auditing, and to accomplish such behind-the-scenes tasks as developing and instituting a system of background checks of potential mentors and creating training and orientation programs for program volunteers.
In just a few short years, One 2 One Mentors has grown to the point where it now provides services to more than 1,400 youth and their families each year. Most youth in One 2 One’s programs are referred by their schools or by the probation system, often for issues related to anger management. The youth are placed in the STAR (Supporting Teens At Risk) program, a 12-week program that helps participants address the issues underlying their anger with a curriculum that covers building healthy relationships, domestic violence prevention, grieving, confidence building and substance abuse prevention.
While the school-based STAR program is able to serve many youth, the number of those who can be matched with mentors is limited by the availability of volunteers who can commit to a one-year involvement.
“Learning how to build healthy relationships is an important skill for these youth,” said Kenneth Rose, operations manager for One 2 One Mentors. “Many of them are new to the community. They may be dealing with modified family situations. They are grieving losses of friends and a familiar school or neighborhood. And they find themselves feeling bored and living in a community where there is not much to do.”
A successful relationship with an adult mentor can be a catalyst for positive behavior change.
Expanding To Serve a Growing Population of Exploited Workers
 Los Angeles is one of the main points of entry for trafficked persons from Asia and Latin America. Thousands of women, men and children have been brought to Southern California and forced into labor in domestic work, sweatshops, light manufacturing and prostitution. Lack of access to education and vocational opportunities in their home countries – along with factors such as war, economic upheaval, natural disasters and globalization – create an environment where people become vulnerable to traffickers.
Trafficked victims are often held for years at a time without access to medical care, mental health services or preventive health services. With the help of the Coalition Against Slavery and Trafficking (CAST), victims of trafficking are removed from exploitive situations where they are forced to work and sleep. They gain access to health care and case management services that assist them in qualifying for Medi-Cal and other health benefits.
CAST was established in 1998 following the exposure of a garment factory in El Monte that kept its Thai workers essentially in slavery. It quickly grew from an organization staffed by volunteers to one with about a dozen paid staff and a budget of more than $1.5 million. It faced a number of organizational challenges resulting from this early success, culminating in the receipt of a $1 million federal grant to open a shelter for victims of trafficking, the first of its kind in the country.
To address some of these organizational challenges, CAST received a three-year TCWF grant of $135,000 in 2004 to provide intensive case management and transition services, outreach and education to service providers and law enforcement personnel on the health issues connected with trafficking, and to develop a fundraising plan to help strengthen its infrastructure.
“No one service delivery model fits all trafficked clients,” said Kay Buck, CAST executive director. “Some clients need immediate access to medical or dental care; others have urgent needs that must be addressed first. We need the flexibility to support them with appropriate services. Core operating support plays such an important role in helping fund services that may not fit into government funding streams.”
CAST’s fundraising plan centers on diversifying its funding base to become less reliant on government grants. Staff and board members are working to build a deeper individual donor base and are exploring special events as a new strategy. Its core support grant has helped support this development plan, which is particularly important for CAST’s long-term success, as services for trafficking victims compete with law enforcement’s efforts for government funds.
“While this new emphasis on the pursuit of traffickers is clearly important, it creates a strain on the organizations like CAST who provide a lifeline for the individuals that are freed,” said Fatima Angeles, TCWF program director. “Core operating support funding can ensure that access to health care is maintained for vulnerable workers.”
Information about the organizations in this article can be found at:
Central Valley Health Network
www.cvhnclinics.org
One 2 One Mentors
(760) 245-1997
CAST
www.castla.org |
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